Can medical marijuana help kick New York's opioid habit?

Valley to build $735M hospital in Paramus

Valley Health System announced Friday that it plans to relocate its Ridgewood, N.J., campus to a $735 million, 372-bed hospital it will build 2.5 miles away on Winters Avenue in Paramus. The move follows a failed decade-long effort to double the Ridgewood facility's square footage. The Concerned Residents of Ridgewood opposed that plan and mired it in regulatory and legal delays. "This came up as a viable alternative," said Audrey Meyers, president and chief executive of the health system and its Valley Hospital. "It will be easier to build out and is not in an immediate residential neighborhood." The 28-acre Paramus site already includes Valley's Luckow Pavilion, a 128,000-square-foot cancer care and ambulatory surgery center. Valley's Ridgewood campus will house the system's business offices, an urgent care center and ambulatory care, laboratory, radiology and endoscopy services. The New Jersey Department of Health must approve the hospital's certificate-of-need application. The new facility will house 79 fewer beds, many of them in single-bed rooms to reduce infection rates, Meyers said. "Inpatient activity has declined over the years," she said, "and with new ways of caring for patients, we think that will continue." —J.L.

Centers CEO to buy bankrupt Queens nursing home

Kenneth Rozenberg, the CEO of Centers Health Care, has purchased the operating interests of the bankrupt Far Rockaway Nursing Home in Queens through a limited liability company for $2.5 million. A Public Health and Health Planning Council committee approved the sale Jan. 26. The operators of the facility had been the estates of six deceased individuals. "Until we approve this we have a nursing home run by no living soul," said Dr. Glenn Martin, a PHHPC member. Daniel Sheppard, a deputy commissioner for the state Department of Health, explained that it had been "very challenging" to get the various members of the estates to agree to a deal. "This path is a way of rectifying that ownership structure and holding someone accountable," he said. Jeffrey Kraut, PHHPC chair and executive vice president for strategy and analytics at Northwell Health, said the sale exemplified the need for regulations that limit the amount of time an estate can own a nursing home. The nursing home filed for Chapter 7 bankruptcy in June. The trustee sold the property for $3 million to an LLC controlled by Daryl Hagler, who has acted as a landlord to Rozenberg's nursing homes in the past. Of the facility's residents, 90.6% paid for care through Medicaid and 9.1% paid through Medicare. After losing money for the past two years, the facility earned $204,543 on $6.2 million in revenue through the first nine months of 2016, according to financial statements submitted with the application. In March 2015, the facility entered into a consulting agreement with Bronx-based Centers Health Care, which runs more than 30 nursing and rehab facilities in New York, New Jersey and Rhode Island. —J.L.

Montefiore struggles to fund study on cannabis and opioids

Doctors at Montefiore Health System are struggling to gain approval from the National Institutes of Health for a clinical trial that would examine how medical marijuana affects opioid use at the individual level, said Dr. Chinazo Cunningham, an internist at Montefiore Medical Group's Comprehensive Health Care Center. The goal is to conduct the study in collaboration with local dispensaries to ensure the products used by participants are consistent with what's on the legal market, Cunningham said. But the NIH has responded to the grant proposal by suggesting the researchers use cannabis from a government source and administer it to patients themselves. "We're trying to argue, from a public health standpoint, that it's more important to know what people are doing and how they're doing it," she said. The U.S. Drug Enforcement Administration's decision to maintain marijuana's status as a Schedule I drug has restricted cannabis research. Cunningham in 2014 co-authored a study published in JAMA linking state medical marijuana laws to reduced rates of opioid overdose deaths. —C.L.

AT A GLANCE

FINANCE FETE: The Healthcare Financial Management Association's metro New York chapter will hold its annual institute March 9-10 at the Long Island Mariott in Uniondale, L.I. Speakers include Northwell Health senior vice president Dr. Ram Raju, EmblemHealth chief executive Karen Ignagni and Bea Grause, president of the Healthcare Association of New York State.

CORRECTION: The Visiting Nurse Service of New York is no longer a client of Cureatr. That fact was misstated in the Jan. 25 Health Pulse article, "Cureatr names ex-Highmark chief as new CEO."

Can medical marijuana help kick New York's opioid habit?

Since getting her medical marijuana card in March, Judy Andino, a paralegal from Monroe, N.Y., has stopped taking the opioid painkillers she was on for nearly four years, replacing them with a few puffs each day on a skinny black vaporizer pen filled with cannabis oil. "It doesn't take away my pain completely, but it's given me the ability to deal with it and function," said Andino, who suffers from peripheral neuropathy and ankylosing spondylitis.

Andino gets her cannabis prescriptions from Dr. Junella Chin, an osteopath with clinics in Manhattan and White Plains, who has certified about 250 patients in the last year. Many have been able to reduce their use of potentially addictive opioid painkillers or cut them out altogether, Chin said.

Chin's experiences, and those of other doctors who spoke to Crain's, echo recent studies linking medical marijuana legalization to fewer opioid prescriptions and overdose deaths. States with legally protected dispensaries have seen a reduction of at least 16% in opioid overdose deaths and at least a 28% drop in admissions for treatment of opioid addiction, according to a 2015 working paper by the Rand Corp.

The state Health Department's proposal to allow anyone with severe pain lasting at least three months to access medical marijuana would allow more patients to use cannabis as an alternative to opioids, proponents say. But most doctors in New York are still reluctant to embrace the drug as a medical treatment. Only 833 physicians, about 1% of the state's total, are certified to recommend it. Those resisting the move toward cannabis cite a paucity of conclusive research on its efficacy, a lack of insurance coverage and tension between state and federal laws.

There's also a fear of repeating past mistakes.

"We saw what a mess happened with opioids," said Dr. Houman Danesh, director of the Integrative Pain Management Division at Mount Sinai Hospital. "We don't want to cause the same mess with marijuana."

Making a real dent in the opioid epidemic will require doctors and insurers to stop relying on drugs as the first line of defense against pain, said Dr. Andrew Kolodny, former chief medical officer of Phoenix House and current co-director of opioid policy research at Brandeis University's Heller School for Social Policy and Management.

"I do think it makes more sense to try patients on cannabis than opioids," Kolodny added when pressed to compare the two. "And I do think if we stop putting chronic-pain patients on long-term opioids and instead prescribe cannabis, that potentially will have a helpful effect in the long term on our opioid crisis."

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